5 Things Not covered by NDIS plan

The National Disability Insurance Scheme (NDIS) has been a game changer, offering essential support and services to people with disabilities and their families. However, as comprehensive as the NDIS can be, there are still certain limitations and exclusions within the scheme that participants should be aware of.

Five things not covered by your NDIS plan are your day-to-day living expenses, services that can be provided by other government agencies, supports that are not directly related to your disability, any supports that may cause harm to you or anyone else, and income replacement of any kind.

At Maple, we understand that these exclusions can sometimes lead to confusion and frustration and we want you to be able to navigate the system with clarity and confidence. What is not covered by the NDIS is often an overlooked aspect of NDIS planning.

Understanding these limitations is essential for NDIS participants, their families and their support network as we minimise any disappointment and encourage you to seek alternative solutions to ensure your unique needs are adequately addressed.

What are some things that are not funded or provided by the NDIS?

Although each individual’s NDIS plan and funding allocation will be distinct to their own unique needs and include different supports based on their personal goals, there are certain items and services that are not covered by NDIS funding. Let’s delve deeper into five of the main things that are not funded by the NDIS.

    1. The NDIS doesn’t fund day-to-day living expenses

The NDIS primarily covers disability-related expenses and support. However, it doesn’t cover ordinary living expenses such as rent or mortgage payments, utility bills, groceries, or clothing that are not attributable to or caused by your disability.

This is because the NDIS serves as a bridge, addressing the challenges people living with a disability face that those who don’t live with a disability may not. If a day-to-day living expense is generally covered by the personal finances of someone living without disabilities, it is not directly related to your disability and is not likely to receive funding through the NDIS.  

However, as with many aspects of the NDIS, the situation is not always straightforward. The NDIS takes a personal approach, they consider your specific circumstances to determine what funding you need and the purpose you need it for. You should discuss any expenses you believe are related to your disability with your plan manager.

    2 .The NDIS doesn’t fund services provided by other government departments

Australia’s government operates with various departments and agencies responsible for different aspects of social welfare, healthcare, education, housing, and other services. Each department has a specific mandate and funding allocation. The NDIS focuses on disability-related supports and services that other government departments do not provide.

When you live with a disability, navigating the system and understanding which department to go through to get funding and support can be complex. The NDIS works in conjunction with other government services and occasionally there can be an overlap of supports. 

The three main government services that cause the most confusion for who funds what are healthcare, education and Centrelink. Generally, the three services cover the following:

• Medical and healthcare expenses such as hospital stays, prescription medication, or other healthcare-related expenses are typically covered by the healthcare system or private health insurance.
• Education expenses such as regular school fees or education-related costs would fall under the responsibility of the education system. Your school system will be able to help you navigate who funds what when it comes to education.
• If you receive the Disability Support Pension, this comes from Centrelink. This is considered a separate payment and it won’t be affected by your NDIS funding. 

    3. The NDIS doesn’t fund supports unrelated to a disability

There must be a direct link or connection between your disability and the support that is funded under the NDIS. Supports that are wanted or needed by anyone, regardless of whether they have a disability or not, are not funded by the NDIS. For example, if you wanted: 

• Household furniture not related to your disability, such as a couch;
• Luxury or non-essential items or services such as holidays or high-end electronics;
• A gym membership to work out;
• Home modifications for aesthetic purposes only;
• Activities that don’t align with the participant’s goals;
• Transportation for social or recreational purposes;

These items would not be covered by your NDIS funding unless it can be proven to be related to your disability. 

Of course, this is not always straightforward. There may be exceptions or situations where services can be funded if they indirectly benefit you, but these exceptions are not common, and the NDIS primarily focuses on funding disability-related services.

    4. The NDIS doesn’t fund support that can cause harm to you or someone else

The NDIS will collaborate with professionals to ensure that the supports that are being funded are safe for you and others around you. For example, you may benefit from a high-powered wheelchair. However, the NDIS would need your occupational therapist to submit a report proving that this device would be safe for you to use.

When the NDIS assesses your support funding, ensuring your safety remains a top priority. Nonetheless, they are adept at asking the right questions and giving you the autonomy to shape your choices in alignment with your goals. That’s where the insights and recommendations of professionals, who are familiar with your unique circumstances come into play. They offer valuable guidance in this complex process.

    5. The NDIS doesn’t fund income replacement

The NDIS is not an income support program like the Disability Support Pension is. They do not provide income replacement of any kind. Income support programs are usually administered by the Department of Social Services and have specific eligibility criteria based on factors such as income, assets, and the severity of your disability. These programs are designed to provide financial assistance to people who meet these criteria. 

The NDIS focuses on funding disability-related supports and services to address the specific needs and goals of people living with disabilities. Whereas, income support programs like the DSP provide financial assistance to those who are eligible to help them meet their basic living expenses.

To find out more about what is and isn’t covered by NDIS funding, feel free to reach out to our team.